<?php
/* @var $this PotentialCustomersController */
/* @var $model PotentialCustomers */
/* @var $form CActiveForm */
?>

<div class="wide form">

<?php $form=$this->beginWidget('CActiveForm', array(
	'action'=>Yii::app()->createUrl($this->route),
	'method'=>'get',
)); ?>

	<div class="row">
		<?php echo $form->label($model,'potential_customers_id'); ?>
		<?php echo $form->textField($model,'potential_customers_id'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'potential_customers_list_id'); ?>
		<?php echo $form->textField($model,'potential_customers_list_id'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'first_name'); ?>
		<?php echo $form->textField($model,'first_name',array('size'=>50,'maxlength'=>50)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'last_name'); ?>
		<?php echo $form->textField($model,'last_name',array('size'=>50,'maxlength'=>50)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'gender'); ?>
		<?php echo $form->textField($model,'gender',array('size'=>50,'maxlength'=>50)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'mobile'); ?>
		<?php echo $form->textField($model,'mobile',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'email'); ?>
		<?php echo $form->textField($model,'email',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'address'); ?>
		<?php echo $form->textField($model,'address',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'post_code'); ?>
		<?php echo $form->textField($model,'post_code',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail1'); ?>
		<?php echo $form->textField($model,'customer_detail1',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail2'); ?>
		<?php echo $form->textField($model,'customer_detail2',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail3'); ?>
		<?php echo $form->textField($model,'customer_detail3',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail4'); ?>
		<?php echo $form->textField($model,'customer_detail4',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail5'); ?>
		<?php echo $form->textField($model,'customer_detail5',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail6'); ?>
		<?php echo $form->textField($model,'customer_detail6',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail7'); ?>
		<?php echo $form->textField($model,'customer_detail7',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail8'); ?>
		<?php echo $form->textField($model,'customer_detail8',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail9'); ?>
		<?php echo $form->textField($model,'customer_detail9',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'customer_detail10'); ?>
		<?php echo $form->textField($model,'customer_detail10',array('size'=>60,'maxlength'=>255)); ?>
	</div>

	<div class="row buttons">
		<?php echo CHtml::submitButton('Search'); ?>
	</div>

<?php $this->endWidget(); ?>

</div><!-- search-form -->